Download Survey of Activities at the County Level

Survey of Activities at the County Level
Aim
A prerequisite for a successful work to minimize the emergence of antibiotic resistance is recognition
of the problem and activities at the local level. In 2003 a nationwide survey was conducted to get an
overview of the local organization, its resources and barriers in the Swedish counties.
Method
All twenty-one county councils have been visited by a specialist in infectious diseases and a
pharmacist. Both of them have participated in meetings with all twenty-four regional STRAMA
groups. Furthermore interviewed were held with the heads of the following units; communicable
disease control, infectious diseases, microbiological laboratories and infection control sections. In
addition, they interviewed all directors of county councils, county council primary care units, and
drug committees. In connection to this all pharmacists working in a STRAMA group was formed
into a network.
The proposal for a “National Action Plan Against Antibiotic Resistance” has been used as the
basis of discussions and interviews. The intention was to review the following factors, stated in the
action plan, that are regarded the most significant in prevention of resistance development:
● resources and methods of resistance surveillance
● surveillance of antibiotic use
● prevention of infectious diseases
● improved diagnostic methods
● improved antibiotic therapy
● education and information
Preliminary results
Already at this point it is clear that this inventory will help to bring forward good examples of wellfunctioning local networks for prevention of resistance development. Concurrently it will point out
obvious shortcomings in health and medical care preventing efficient STRAMA work:
● lack of resources for infection control: in eight of the counties the accessibility for doctors within
the hygiene sector is only ten hours or less per week.
● lack of single rooms with private WC and shower facilities; in more than half of the Swedish
county councils, less than 20 percent of the in-patients have access to such rooms.
● acute wards with shortages of beds with isolation care facilities; 90 percent of the county councils
are reported to have such shortages.
● lack of competence in the area of medical care and infection control within nursing homes; half of
the Swedish municipalities lack in hygiene competence at their nursing homes.
● lack of infectious disease specialists at certain hospitals; in six counties there are hospitals lacking
such competence.
● resource related obstacles for continuous training of health care workers within the area of
infectious diseases and antibiotic use
● in only seven of the twenty-one counties an automatic annual report on antibacterial resistance
within the region is fed back to physicians.
The result of the inventory will also be returned to all local STRAMA groups and will constitute a
basis on which to set a program for educational training days throughout 2004 and ahead.
Seth-Olof Bergquist